Patient autonomy

Patient autonomy means ensuring that patients make informed decisions and give consent based on good information. It is important not to make assumptions about what patients/clients and their carers want, but to work in partnership for the best outcomes.

Introduction

All of the activities in this unit help you to learn about how culture influences that the care that is provided; the importance of taking diversity and individuals’ beliefs and preferences into account when providing care; and about the legislative requirements and policy in relation to equality and diversity.

Providing person centred care involves:

demonstrating cultural competence

patient/client autonomy and ensuring that people receiving care can make informed decisions and give consent based on good information

co-production of care - including people as equal partners in decisions about their care

empowering people to be part of decision making processes about things that impact on them and their care.

The activities below will help you understand more about how you can be part of this happening in your work setting for the people that you provide care for.

You will also find the ‘Patient Client Involvement’ section in the Policy Unit useful and in particular the ‘Challenges to PFPI’ when considering Patient/client autonomy, inclusion and empowerment.

Keeping up to date with Everyone Matters: 2020 Workforce Vision

Find out what your local Health Board Everyone Matters: 2020 Workforce Vision plans are. You will find these by searching on the intranet or internet.

What impact do these plans have for clients/patients, your role and work setting?

Keep up to date with Everyone Matters: 2020 Workforce Vision by adding a bookmark to the relevant intranet or web page and an alert to your Flying Start NHS® portfolio and /or make a date in your diary to revisit.

Assets-based approaches

Health assets have been defined as: “any factor or resource which enhances the ability of individuals, communities and populations to maintain and sustain health and wellbeing and to help to reduce health inequalities. These assets can operate at the level of the individual, family or community and population as protective and promoting factors to buffer against life’s stresses.” (Morgan and Ziglio 2007 cited by the Scottish Recovery Network).

Thinking about your values

Your values and beliefs influence the care that you provide (this is explored in the Cultural Competence section of this unit) and you need to be aware of how this impacts on the care that you provide and how you see the needs of your patients/clients.

Including everyone

Taking into account equality, diversity, culture and socioeconomic influences is central to the provision of person centred health services.

Think about the Equality Act (2010) protected characteristics’ (age, disability, gender reassignment, race, religion or belief, sex, sexual orientation, marriage and civil partnership, pregnancy and maternity)., diversity of the people who work in and access your service; socioeconomic and geographic factors impacting on people who display any of these characteristics. Answer the following questions:

can you identify factors that may impact on people having equal access to services? This may be supportive, can hinder or prevent access

how does or could the service be flexible or adapt to ensure equal access for everyone?

are there factors that impact on staff members that also need to be considered?

Discuss any issues that you have identified with your mentor or manager and also highlight where thing are working well.

Co-production – working with patients/clients

an assets approach which builds on the skills, knowledge, experience, networks and resources that individuals and communities bring

built on equal relationships, where individuals, families, communities and service providers have a reciprocal and equal relationship

an approach where services ‘do with, not to’ the people who use them and who act as their own catalysts for change’ (Hanley,2013 p14)

This is the direction that healthcare in Scotland is moving and is central to person centred care. It differs from the traditional model of healthcare where healthcare professionals make decisions about the care and treatment that people receive.

Can you identify:

aspects of the care that is provided by your service where the traditional approach is taken

aspects of care that have elements of coproduction

how equality and diversity might affect your approach to co-production

where care could be adapted to move towards coproduction

how carers, family or friends could be included in planning and carrying out care if this is appropriate